cataract and glaucoma

Question 1

What are glaucoma’s associated with ?

Answer 1

Increased intra-ocular pressure. They are optic neuropathies and result in damage to the optic nerve with loss of vision.

Question 2

Describe the signs of open-angle glaucoma

Answer 2

Painless so screening at check-ups is essential.

Gradual visual-field loss

Question 3

what is the mechanism of open-angle glaucoma

Answer 3

slow exit of aqueous humour through the trabecular meshwork of the eye

Question 4

Describe the presentation of angle-closure glaucoma

Answer 4

Acute presentation.
Blurring of vision, painful red eye, headache, nausea and vomiting

May also have a chronic form of the disease whch can occur after acute angle closure glaucoma

Question 5

how would you investigate a patient who you suspected of having angle-closure glaucoma?
What would you expect to find?

Answer 5

slit-lamp: shallow anterior chamber. Large optic cup
gonioscopy: trabecular meshwork is not visible as the peripheral iris is in contact with it.
Automatic perimetry: identify the extent of visual field loss

Question 6

how may you manage an acute angle-closure glaucoma in the immediate setting?

Answer 6

carbonic anhydrase inhibitors and/or topical beta-blocker and/or topical alpha-2 agonist to reduce IOP

Question 7

what is a cataract?

Answer 7

Chronic eye condition where the lens gradually becomes opacified.

Question 8

what is the normal cause of cataracts?

Name some other risk factors

Answer 8

Ageing

Smoking and alcohol, trauma, diabetes, long term steroid use

Question 9

how does a cataract present?

Answer 9

o Gradual onset reduction in vision, colour vision
o Glare – lights are brighter than usual
o Halos around lights

Question 10

what sign would point you towards a cataract diagnosis?

Answer 10

a defect in the red-reflex

Question 11

what information would lead you to diagnose a cataract?

Answer 11

detection of a decrease in visual acuity that cannot be corrected by refractive correction, and an eye examination that is otherwise normal apart from opacity in the crystalline lens

Question 12

how are cataracts managed?

Answer 12

o	Conservative 
	Stronger glasses
	Encourage use of brighter lighting 
	Won’t slow down the process 
o	Surgery 
	Patient-dependent as to when the referral is made